论文部分内容阅读
目的分析子宫内膜息肉伴胰岛素抵抗患者的临床及内分泌代谢特征,探讨二甲双胍对于治疗子宫内膜息肉伴胰岛素抵抗患者的临床疗效。方法选取伴胰岛素抵抗并经宫腔镜检查病理证实为子宫内膜息肉患者112例,患者知情同意并选择术后处理方式,56例于术后给予二甲双胍片(二甲双胍组)6个月,其中单发性息肉40例,多发性息肉16例;56例不给予任何处理(对照组),其中单发性息肉42例,多发性息肉14例,观察两组患者随访2年后胰岛素抵抗改善状况及子宫内膜息肉复发。结果 112例患者手术均顺利实施,二甲双胍组体质指数(BMI)、腰围/臀围比(WHR)、空腹胰岛素(FINS)及胰岛素抵抗指数(HOMA-IR)与对照组比较均降低(P<0.05);二甲双胍组子宫内膜厚度[(8.37±1.41)mm]与对照组[(11.45±0.61)mm]比较,差异有统计学意义(P<0.05)。二甲双胍组术后随访(1.44±0.47)年,对照组术后随访(1.49±0.46)年,差异无统计学意义(P>0.05)。二甲双胍组术后2年多发性子宫内膜息肉复发2例,复发率3.57%,对照组术后复发20例,复发率35.71%,其中单发息肉7例,多发息肉13例,两者比较,差异有统计学意义(P<0.05)。结论子宫内膜息肉伴胰岛素抵抗患者宫腔镜术后服用二甲双胍可能有助于改善其胰岛素抵抗现象,并有助于预防子宫内膜息肉的复发。
Objective To analyze the clinical and endocrine and metabolic characteristics of patients with endometrial polyps and insulin resistance and to investigate the clinical efficacy of metformin in the treatment of endometrial polyps with insulin resistance. Methods One hundred and twelve patients with endometrial polyps confirmed by hysteroscopy were enrolled in this study. Patients were informed consent and the way of postoperative treatment was given. 56 patients were given metformin tablets (metformin group) for 6 months after operation, 40 cases of polyps, multiple polyps in 16 cases; 56 cases without any treatment (control group), including 42 cases of single polyps, multiple polyps in 14 cases, two groups were followed up for 2 years to observe the improvement of insulin resistance and Endometrial polyps recurrence. Results The operation of 112 patients was successfully carried out. BMI, WHR, FINS and HOMA-IR in metformin group were lower than those in control group (P <0.05) ). The thickness of endometrium in metformin group [(8.37 ± 1.41) mm] was significantly different from that in control group [(11.45 ± 0.61) mm] (P <0.05). Metformin group was followed up (1.44 ± 0.47) years, control group was followed up (1.49 ± 0.46) years, the difference was not statistically significant (P> 0.05). Metformin group 2 cases of multiple endometrial polyps recurrence after 2 years, the recurrence rate was 3.57%, control group 20 cases of recurrence, the recurrence rate was 35.71%, including single polyp in 7 cases, multiple polyps in 13 cases, The difference was statistically significant (P <0.05). Conclusions The use of metformin after hysteroscopy in patients with endometrial polyps and insulin resistance may help to improve their insulin resistance and help prevent the recurrence of endometrial polyps.